Analysis: There is no guarantee that the plan to alleviate overcrowding at Dublin hospitals will make any real difference, writes Eithne Donnellan
Many patients continue to have to spend time on trolleys in hospital A&E units across the State every day.
If there are no beds on wards when patients attending A&E need to be admitted, a hospital's only options are to accommodate them on trolleys or chairs.
Yesterday the Health Service Executive said it counted 121 patients on trolleys nationwide. The Irish Nurses' Organisation claimed the figure was 205. Whatever the figure and both sets are probably accurate at the time they are collected (one in the morning, one in the afternoon), it is still too many.
A&E overcrowding has been a feature of life in Irish hospitals for years. The knock-on effects on patients are enormous. Some, often elderly, have to spend their entire hospital stays on trolleys in hospital corridors, with no privacy and little opportunity to sleep.
While often at its worst in winter, the A&E problem is now year round.
When Mary Harney took over the health portfolio more than a year ago, she pledged to tackle the problem head-on, announcing a €70 million 10-point plan to address it. About 100 long-stay patients who were taking up beds in acute hospitals but who no longer needed acute hospital care have been found alternative accommodation since, but many aspects of the plan have still not been implemented.
Now the HSE plans to try new initiatives to help solve the crisis in A&E units in Dublin in 2006.
While overcrowding is a problem not just in Dublin, the HSE says it is often at its worst in the capital's hospitals and it is now targeting them.
It will try to ease pressure on beds in hospitals in the capital by stopping patients travelling from the regions for treatment they can get on their own doorstep.
This makes sense for straightforward procedures such as tonsillectomies and hip operations, but whether it will get the co- operation of all doctors to make it work is doubtful.
Already the Irish Medical Organisation and the Irish Hospital Consultants Association have expressed reservations.
They suggest doctors should be able to refer patients wherever they want and to hospitals with shortest waiting times, and express doubt about whether there are enough beds in the regions to operate on more patients.
Already thousands of operations have to be cancelled and rescheduled in the regional hospitals due to pressure on beds.
Only time will tell whether the prediction by HSE deputy chief executive Pat McLoughlin yesterday that the HSE's latest plan will mean "real and measurable improvements" in A&E this year is accurate.
Certainly new developments due to open shortly at the Mater, St Vincent's and St James's Hospital will improve conditions for patients. Other elements of the HSE's plans, if implemented, will contribute to easing difficulties, but on their own they will make little difference.
The reality is that the crisis in A&E units is likely to continue until out-of-hours GP services are improved and more hospital beds are put in place.